Healthcare Provider Details

I. General information

NPI: 1609006832
Provider Name (Legal Business Name): AMS PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12626 RIVERSIDE DR SUITE 509
VALLEY VILLAGE CA
91607-3420
US

IV. Provider business mailing address

12626 RIVERSIDE DR SUITE 509
VALLEY VILLAGE CA
91607-3420
US

V. Phone/Fax

Practice location:
  • Phone: 818-986-9229
  • Fax: 818-986-9339
Mailing address:
  • Phone: 818-986-9229
  • Fax: 818-986-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT 32334
License Number StateCA

VIII. Authorized Official

Name: ALEXANDRA STEIN
Title or Position: CEO
Credential: P.T.
Phone: 818-648-3328